Document Type

Article

Publication Date

10-24-2012

Abstract

Background: Previous studies exploring the association between 25[OH]D levels and mortality in adults with and without kidney disease utilized 25[OH]D thresholds that have recently been scrutinized by the Institute of Medicine Committee to Review Dietary References Intakes for Vitamin D and Calcium. Objective: We explored all-cause mortality rates across the spectrum of 25[OH]D levels over an eighteen-year follow-up among adults with and without an estimated glomerular filtration rate (eGFR) /min/1.73 m2. Design: The study included 1,097 U.S. adults with eGFR /min/1.73 m2 and 14, 002 adults with eGFR ≥60 ml/min/1.73 m2. Mortality rates and rate ratios (RR) across 25[OH]D groups were calculated with Poisson regression and restricted cubic splines while adjusting for covariates. Results: Prevalence of 25[OH]D levels /ml among adults with eGFR /min/1.73 m2 was 76.5% (population estimate 6.2 million) and 35.4% (population estimate 2.9 million), respectively. Among adults with eGFR ≥60 ml/min/1.73 m2, 70.5% had 25[OH]D levels /ml (population estimate 132.2 million) while 30.3% had 25[OH]D levels /ml (population estimate 56.8 million). Significantly higher mortality rates were noted among individuals with 25[OH]D levels /ml compared to referent group (24 to /ml): RR1.41 (95% CI 1.17, 1.71) among individuals with eGFR /min/1.73 m2 and RR 1.32 (95% CI 1.13, 1.56) among individuals with eGFR ≥60 ml/min/1.73 m2 after adjustment for covariates including co-morbid conditions. Mortality rates were fairly similar across all 25[OH]D groups with levels >20 ng/ml after adjustment for all covariates. Conclusions: Regardless of presence of eGFR /min/1.73 m2, mortality rates across groups with 25[OH]D levels 20-40 ng/ml are similar.

Publication Source (Journal or Book title)

PLoS ONE

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